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Praeger seeks quick insurance exchange answer from governor

Kansas Insurance Commissioner Sandy Praeger.

Kansas Insurance Commissioner Sandy Praeger. by Phil Cauthon

Kansas Insurance Commissioner Sandy Praeger said today that she wants to meet this week with Gov. Sam Brownback about how to move forward with implementation of the federal health reform law.

Specifically, Praeger said she wants to talk to Brownback about the state partnering with the federal government on a health insurance purchasing exchange. Kansas no longer has the option of designing its own online insurance marketplace but it can still partner on one with federal officials, if it acts quickly, she said.

Praeger said partnering with the federal government on an exchange would allow the state to maintain its authority to review and license insurance plans.

Praeger, a moderate Republican who supports the reform law, said she must let federal officials know by Friday, Nov. 16 whether the state intends to partner on an exchange. But she said she needs the governor’s blessing on that and a grant application her department has prepared, which must be submitted by Thursday, Nov. 15.

“The governor needs to agree that he won’t oppose us applying for the grant,” Praeger said. “He doesn’t have to give tacit approval necessarily, but just indicate it’s OK if we want to move forward on this.”

Brownback, a conservative Republican, voted against the Affordable Care Act as a member of the U.S. Senate and as governor has tried to block its implementation pending the outcome of a U.S. Supreme Court ruling on the law and then later the outcome of the presidential race.

Brownback in August 2011 rejected a $31.5 million federal grant intended to help Kansas develop an exchange as part of a program to develop models for other states to use.

Praeger said President Obama’s re-election means that the reform law won’t be repealed. It also means that states that have been slow to act will have to play catch up to meet approaching implementation deadlines.

Under the law, each state is to have an exchange operational by Jan. 2014.

“It’s time to stop resisting,” Praeger said.

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Some say new meal guidelines should be scrapped

On Sept. 27, Daily Show host Jon Stewart lampooned last week's media coverage of the video made by Kansas students protesting the new school lunch standards.

On Sept. 27, Daily Show host Jon Stewart lampooned last week's media coverage of the video made by Kansas students protesting the new school lunch standards. by Phil Cauthon

Though this year’s new school lunch guidelines are generally a hit with nutrition experts and school officials, Kansas Congressman Tim Huelskamp, a Republican who represents the state's largely rural 1st District, said that’s not what he’s hearing from parents and students.

“Parents are frustrated that the lower calorie limits are leaving their children hungry, and therefore unable to concentrate in the classroom or without the energy they need to participate in after-school sports,” Huelskamp told KHI News Service.

Weeks after the guidelines went into effect, some students in his district made a music video protesting the guidelines:

Give me some seconds I need to get

some food today My friends are at the

corner store Getting junk so they

don’t waste away.

The video — called “We Are Hungry,” spoofing a pop song by the band Fun — has been viewed nearly 800,000 times already, and last week was covered widely by the national media and was featured on Comedy Central's The Daily Show.

Much of the video shows student athletes without energy and passing out en masse.

However, federally funded school lunches are not intended to serve as a sports training table for student athletes, said Cheryl Johnson, who heads the Child Nutrition and Wellness program at the Kansas State Department of Education.

She said the guidelines were intended to make sure school lunches provide one-third of the average daily calorie needs of students, by age group.

Johnson said that additional helpings of fruits and vegetables remain available and federally subsidized for those who want them and that students who want seconds of other items can always purchase them.

Push to repeal the guidelines

The new guidelines were championed by First Lady Michelle Obama, in part to help stem the rising tide of childhood obesity in the United States. According to the Centers for Disease Control, more than a third of all children in the U.S. were overweight or obese in 2008.

The new guidelines include the first-ever caps on calories provided in school meals, which Huelskamp said were misguided.

“Childhood obesity is certainly a problem in America, but it is not the prerogative of the federal government to put every child on a diet,” Huelskamp said. “It is the right and responsibility of the parents to counter their children’s health issues.”

Huelskamp is co-sponsoring legislation that would repeal the new nutritional guidelines and reinstate the old ones, which had been in place for 15 years.

"The USDA's new school lunch guidelines are a perfect example of what is wrong with government: misguided inputs, tremendous waste, and unaccomplished goals. Thanks to the Nutrition Nannies at the USDA, America's children are going hungry at school," Huelskamp wrote in press release unveiling the “No Hungry Kids Act,” co-sponsored by Iowa Republican Rep. Steve King.

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New kind of Kansas health insurance company in the works

For many, the term co-op evokes images of grain elevators, Depression-era workers stringing electric lines or maybe the more contemporary picture of a place where local-food devotees go to get a weekly helping of fresh produce.

But a group at work in Wichita has a different vision. They are working to develop a member-owned co-op that would provide thousands of Kansans with health insurance. And they want the coverage to be different from plans offered by traditional carriers.

Anne Nelson, associate director of the Central Plains Health Care Partnership in Wichita, an affiliate of the Medical Society of Sedgwick County, said the goal is to create a Kansas cooperative that offers individual and small business coverage that is both affordable and innovative in that it will emphasize patient-centered and preventive care.

“There will be a direct relationship with the people who are served by the products in the plan. If a product isn’t working based on consumer feedback, the consumer leaders (of the cooperative) can make changes,” Nelson said.

If the co-op does well financially, it would be required to use money not needed for claims or state solvency requirements to lower premiums or increase benefits.

Working with a small planning committee that includes health care providers, lawyers, actuaries, insurance experts and representatives of the business community, Nelson is preparing to apply for millions of dollars in federal loans to fund the launch of the nonprofit health insurance cooperative. She said she plans to submit the loan application this fall to the U.S. Department of Health and Human Services, which already has provided nearly $850 million in start-up and sustainability loans to health insurance cooperative in 10 states.

The loans approved earlier this year ranged from around $57 million to a cooperative in Oregon to nearly $175 million to the Freelancers Health Service Corporation, a union-affiliate co-op in New York. Midwest Members Health, which is planning to offer coverage to residents of Iowa and Nebraska, received $107 million.

“We don’t know yet what our application will be. But it’s a multimillion-dollar project,” Nelson said.

Money in health reform law

Creating more competition in the health insurance marketplace is one of the objectives of the controversial and still not-well-understood Affordable Care Act. The health reform law authorizes $3.4 billion in low-cost federal loans to start and help sustain at least one consumer-governed health plan in each state

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